Child maltreatment and cardiovascular disease risk: examining psychosocial and immunological pathways in a prospective, longitudinal cohort

儿童虐待和心血管疾病风险：在前瞻性纵向队列中检查心理社会和免疫途径

• 批准号: 10543995
• 负责人: Hannah Milena Caroline Schreier
• 金额: $ 62.2万
• 依托单位: PENNSYLVANIA STATE UNIVERSITY, THE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-01-15 至 2025-12-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10543995
• 关键词: Adult; Adverse effects; Age; Aging; Anti-Inflammatory Agents; Behavior assessment; Biological; Biological Markers; Blood Pressure; C-reactive protein; Cardiovascular Diseases; Cessation of life; Characteristics; Child Abuse and Neglect; Child Health; Childhood; Chronic; Chronic Disease; Chronic stress; Coupled; Data; Development; Diagnosis; Elderly; Environment; Ethnic Origin; Exposure to; Family; Funding; Future; Gender; Glucocorticoids; Glycosylated hemoglobin A; Goals; Health; Health Care Costs; Health behavior; Healthcare; High Density Lipoprotein Cholesterol; Immune response; Immunologics; In Vitro; Inflammation; Inflammatory; Insulin; Interdisciplinary Study; Intervention; Investigation; Leukocytes; Life; Life Style; Link; Literature; Longitudinal cohort; Low-Density Lipoproteins; Measures; Medicaid; Morbidity - disease rate; National Institute of Child Health and Human Development; Obesity; Outcome; Participant; Pathway interactions; Personal Satisfaction; Phenotype; Physiological; Play; Population; Prevention; Procedures; Process; Production; Productivity; Prospective Studies; Prospective cohort; Psychosocial Assessment and Care; Psychosocial Factor; Public Health; Race; Recording of previous events; Records; Regulation; Research; Rest; Risk; Risk Reduction; Role; Sampling; Services; Severities; Sexual abuse; Signal Transduction; Stress; Survivors; Testing; Time; Triglycerides; Universities; Virus Latency; Vulnerable Populations; Well in self; Youth; aged; biopsychosocial; boys; cardiometabolic risk; cardiovascular disorder prevention; cardiovascular disorder risk; case control; cohort; cost; cytokine; disorder risk; early adolescence; early life adversity; early life stress; experience; girls; health care service utilization; health difference; health disparity; health record; high risk; immune function; immune health; improved; insight; maltreatment; microbial; mortality; neglect; novel; peer; personalized intervention; physical abuse; primary caregiver; prospective; protective factors; psychologic; psychosocial; recruit; response; sociodemographics; stressor

Child Maltreatment and Cardiovascular Disease Risk: Examining Psychosocial and Immunological Pathways in a Prospective, Longitudinal Cohort PI: Hannah M. C. Schreier PROJECT SUMMARY / ABSTRACT Over one third of U.S. youth are investigated for child maltreatment (CM) before the age of 18. CM represents an especially potent early life stressor with a profound impact on youth’s psychological and physical well-being. Among other things, CM increases the risk for cardiovascular disease (CVD), which is responsible for 32% of all deaths in the U.S. and the roots of which can already be found during childhood. Thus, a better understanding of the physiological mechanisms through which CM is associated with increased CVD risk is needed to improve the lifelong health trajectories of youth with a CM history, a high-risk yet understudied group, as well as to better understand biological mechanisms connecting early life adversity to later life health more generally. The proposed project will build on the currently ongoing Child Health Study (CHS; HD089922, PI: Noll, Co-I: Schreier), as part of which 675 youth aged 8-13 years who were recently investigated for CM as well as 225 comparison youth without a history of CM are being recruited and followed prospectively. Taking advantage of this unique and exceptionally well-characterized cohort, we will augment the biopsychosocial data already being collected to examine in-depth immune function outcomes. To this end, this project will assess stimulated pro- and anti-inflammatory cytokine production following in vitro microbial challenge, sensitivity to glucocorticoid signaling among white blood cells, and, finally, latent virus regulation, all across multiple timepoints. This will allow us to investigate prospectively and in detail the associations between exposure to CM and immune function outcomes and will be the first study to do so in a sample of recently maltreated youth. Additionally, we will be able to link the resulting immune function outcomes to early indicators of CVD risk among these youth, both by linking to existing measures of cardiometabolic risk in the cohort and further by linking to youth’s administrative records, specifically Medicaid claims data. This will be the first study to examine connections between immune function outcomes and CVD-relevant health care use among youth. Finally, we will be investigating the extent to which malleable protective factors, including youth lifestyle, family and peer environments, may protect youth from the adverse effects of CM on altered immune function outcomes and the extent to which key demographic moderators (age, pubertal stage, gender, race/ethnicity, CM severity) play a role. The interdisciplinary research team includes expertise in the assessment of immune function outcomes and CVD risk among vulnerable youth; the recruitment and retention of prospective cohorts of CM survivors; and the use of administrative records to answer questions pertaining to the well-being of youth with a history of CM. Resulting data will make important contributions to the CM and early life adversity literatures. It will also inform future prevention and intervention efforts with the ultimate goal of reducing the risk of adverse long-term health consequences among some of the most vulnerable individuals in the population as well as reducing the healthcare costs resulting from CM.

儿童虐待和心血管疾病风险：检查心理和免疫学途径 前瞻性的纵向队列 PI：Hannah M. C. Schreier 项目摘要 /摘要 在18岁之前，对美国青年的三分之一进行了调查。 一个特别潜在的早期生活压力源，对青年的心理和身体健康产生深远的影响。 除其他事项外，CM增加了心血管疾病（CVD）的风险，该疾病造成32％ 美国的所有死亡以及童年时期已经发现的根源。那，更好 了解CM与CVD风险增加相关的物理机制是 需要改善具有CM历史的年轻人的终身健康轨迹，这是一种高风险 小组，以及更好地了解将早期生命冒险与以后健康健康联系起来的生物学机制 更普遍。拟议的项目将基于当前正在进行的儿童健康研究（CHS； HD089922， PI：Noll，Co-I：Schreier），作为675名8-13岁的青年，最近接受了CM的调查 随着225个没有CM病史的比较年轻人正在被招募和前瞻性。服用 这个独特且特征良好的同类队列的优势，我们将增强生物心理社会 已经收集了数据以检查深入的免疫功能结果。为此，这个项目将 评估在体外微生物挑战之后刺激的促促促促促血统和抗炎细胞因子的产生， 对白细胞中糖皮质激素信号的敏感性，最后是潜在病毒调节 多个时间点。这将使我们能够前瞻性地调查，并详细研究 暴露于CM和免疫功能结果，将是最近在最近的样本中进行的研究 虐待青年。此外，我们将能够将产生的免疫功能结果与早期联系起来 这些年轻人中CVD风险的指标，都通过与现有的心脏代谢风险措施联系在一起 通过与青年的行政记录，特别是Medicaid索赔数据的链接，并进一步链接。这将是 首次研究免疫功能结果与CVD相关的医疗保健使用之间的联系的研究 在青年中。最后，我们将调查包括青年在内的可延展保护因素的程度 生活方式，家庭和同伴环境可能会保护青年免受广告对免疫改变的不利影响 功能结果和关键人口统计学主持人的程度（年龄，青春期，性别，性别， 种族/种族，CM严重性）发挥作用。跨学科研究团队包括 弱势青年评估免疫功能结果和CVD风险；招聘和 保留前瞻性CM存活群体；以及使用行政记录回答问题 与CM史的年轻人的福祉有关。结果数据将为 CM和早期的广告文学。它还将为未来的预防和干预工作提供信息 最终目标是减少一些最大的长期健康后果的风险 人口中脆弱的人，以及降低商业造成的医疗保健费用。